[The clinical assessment of immunological tests in hip replacement].

The reaction of organism to hip replacement was studied in 75 patients. The reaction developed in response to operative intervention either immediately after the operation (within 1-3 months) or to the beginning of the active functioning of the artificial joint (from the 6th month after operation). The development of complications after implantation of the endoprosthesis was followed by certain shifts of immunological indices. Prognostic criteria of the development of the implant instability before operation were a reduced level of immunoglobulin G and higher concentration of immunoglobulin E, in the long term period they are an increased level of IL-1 and of the content of cytoplasm cationic proteins of neutrophils.

[Immunological monitoring in the surgical treatment of damages to the thoracic and lumbar parts of the vertebral column].

Adequacy of diagnostic actions, choice, on their basis, of a treatment for patients with vertebral fractures and spinal cord injury, improvement of the results of surgical treatment are anactual problem of modern traumatology and neurosurgery. The purpose of the study was to define the role of immunological monitoring in the evaluation of patients' condition in the presence of spinal damage. Blood was tested in 111 patients during two-stage surgical treatment for spinal damages: 1) osteosynthesis by an external fixation device and 2) anterior spinal fusion. The results of general clinical blood checks, lymphocytic phenotyping, determination of neutrophilic functional and metabolic activity, the levels of circulating immune complexes and immunoglobulins, the concentrations of cytokines (IL-1alpha, IL-1beta, IL-1ra, IL-8, tumor necrosis factor-alpha) and acute-phase proteins were estimated before surgery and in different periods up to 6 months inclusive. Statistical studies were conducted using the STATISTICA program. Examination of three groups of patients (two of which had postoperative complications, the other was a control group) has ascertained that immunological monitoring in the treatment of spinal injure may be used to predict postoperative complications, such as delayed consolidation and impaired formation of a bone block in the vertebral segment, be made in different management periods (before surgery and on follow-up days 2 or 10), and include prognostic tests, by taking into account the capacities of a laboratory service.

[Informative power of immunological parameters in prognosis of postoperative complications in hip joint replacement]. / Informativnost' immunologicheskikh pokazatelei v prognozirovanii posleoperatsionnykh oslozhnenii pri éndoprotezirovanii tazobedrennogo sustava.

A retrospective analysis of clinical-and-immunological data as well as regressive analysis were used to detect the prognosticated signs of acute postoperative pneumonia in hip-joint replacement. The concentration of serum immunoglobulins and parameters of the blood phagocyte condition were found to be highly informative.

[Immunological monitoring of bone tissue resorption following endoprosthesis of large joints]. / Immunologicheskii monitoring rezorbtsii kostnoi tkani pri éndoprotezirovanii krupnykh sustavov.

There was noted a reaction of the immune system to big-joint replacements, which developed both as a stereotype acute-phase response to the surgical intervention and a moderate immunosuppression, and as a response to the functioning of the implant (beginning from month 6 after surgery), when a mild phagocytes' activity and moderate changes in the acute-phase proteins were registered. Later, the monocyte-lymphocyte reaction of blood involving a higher production of osteoresorptive IL-1 and TNF were observed during the shaping resorption of osseous tissue. Complications can be prognosticated on the basis of the below: contents of leukocytes' main populations; activity of cytoplasm cation proteins; and concentration of the main classes of immunoglobulins and of IL-1.